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DEPARTMENT OF OPHTHALMOLOGY, UNIVERSITY OF AUCKLAND: FELLOWSHIP DESCRIPTION: MEDICAL RETINA Location 1. Department of Ophthalmology, New Zealand National Eye Centre Faculty of Medical and Health Sciences, Grafton Campus, University of Auckland 2. Department of Ophthalmology, Greenlane Hospital, Auckland 3. Manukau Superclinic, Manukau, South Auckland Head of Department: Professor Charles NJ McGhee MB, PhD, FRCS, FRCOphth, FRANZCO, FRSA Maurice Paykel Professor and Chair of Ophthalmology Director, New Zealand National Eye Centre Principal Supervisor of Fellow: Dr Mark L Donaldson MB FRANZCO Dr David Squirrell MB FRCOphth Medical Retina Team (N=9) Dr Dr Dr Dr Dr Dr Dr Rachel Barnes MB FRANZCO Mark L Donaldson MB FRANZCO Tahira Malik MB FRCOphth Alison Pereira MB FRCOphth Andrew Riley MB FRANZCO Dianne Sharpe MB FRANZCO Joanne Sims MB FRANZCO Fellowship Contact Details: Professor Charles NJ McGhee Maurice Paykel Professor and Chair of Ophthalmology Department of Ophthalmology, Faculty of Medical & Health Sciences, The University of Auckland, Private Bag 92019, Auckland, New Zealand Telephone Facsimile Email Website 64 9 9236712 64 9 367 7173 [email protected] http://www.ophthalmology.auckland.ac.nz 1 Fellowship Objectives: 1. To gain exposure in the assessment, diagnosis and management of medical retinal conditions to prepare a candidate for a clinical academic career with subspecialty training in medical retina. 2. To enhance registrar and undergraduate medical student teaching and provide clinical and surgical supervision for registrars where appropriate. 3. To pursue clinical or laboratory research within, or in conjunction with, the Department of Ophthalmology, University of Auckland. 4. To provide clinical and administrative support to the medical retina service. General description: This fellowship is offered to prepare suitable candidates for a clinical/academic career in ophthalmology. This includes appropriate clinical and surgical skill acquisition in order to be considered a sub-specialist in the field of medical retina as well as involvement in basic and clinical research in the area. Clinical Duties: A principal clinical duty is to support the Auckland Central diabetic retinopathy photoscreening programme. Digital photographs are taken at the diabetes clinic Greenlane hospital. They are reviewed remotely in the Eye Department by a dedicated group of primary graders comprising nurses, optometrists and ophthalmic photographers. The medical retina fellow is responsible for directly overseeing this process, reviewing all positive images, reviewing a percentage of negative images and auditing the programme. Retinal surveillance of diabetics is a large responsibility of any medial retina consultancy and past fellows have witnessed several evolutionary developments as well gaining from research. Further duties comprise assessing, diagnosing and treating referred subspecialty patients in an outpatient setting in the Auckland District Health Board Ophthalmology Service, Greenlane Hospital and Manukau Superclinic, South Auckland. A typical tensession week would comprise seven clinical sessions, one operating session and two research/admin/university sessions. There is no official on-call out of hours commitment, however, the fellow must carry a cell-phone at all times (except when on vacation), and will avail him/herself for consultation to registrars and emergencies referred by outside ophthalmologists. Auckland District Health Board with ophthalmology services at Greenlane Hospital is a major tertiary service provider with a catchment population of over 1.3million and around 55,000 ophthalmology outpatient attendances per annum. This is an ideal opportunity to spend a year in New Zealand and for the fellow to immerse her/himself in the whole spectrum of medical retina problems in a busy teaching hospital. The unit is a centre of excellence for North Island New Zealand with a number of supra-regional services including electro-diagnostics, ocular genetics, ocular oncology and uveitis as well as a number of regional services including vitreo-retinal surgery and research into anti-angiogenics. 2 South Auckland, in particular, has an extremely high prevalence of type II diabetes. Patients frequently present late and consequently the medical retina clinics here provide exceptional exposure to advanced disease. Previous fellows have commented that these “serve as a master-class” for the management of diabetic retinopathy and its associated complications. Auckland is also fortunate enough to be in the forefront of research using the antiangiogenics; Bevacizumab (Avastin), and Anecortave acetate (Retaane) for AMD and DME and the steroid implant Posurdex for retinal vein occlusions and diabetic macular oedema. The Medical Retina Fellow is heavily involved in running the acute macular clinic, the purpose of which is to triage, treat and monitor patients who would benefit from these new therapeutic modalities. The Fellow also has the opportunity to serve on the diabetes subcommittee whose remit is the delivery of diabetic eye care to the population of South Auckland. These activities provide valuable managerial experience that provides insight into the clinical and non-clinical challenges that arise in delivering such a service. The Fellow’s current weekly timetable comprises: 2.5 Medical retina clinics (Green Lane and South Auckland) 1.0 Diabetic retinopathy photo-reading programme (Green Lane) 2.5 Laser clinics (Green Lane and South Auckland) 1.0 Electro-diagnostics session/ fluorescein reporting (Green Lane) 1.0 General theatre session (Green Lane) 1.0 Medical retina research clinic 1.0 Admin/research/university session Research: The fellow will be expected to spend 10-20% of his/her time on aspects of clinical research. Several clinical science projects will be outlined for the fellow and he or she will be expected to participate in one or two and present these at Research Day and in the Department of Ophthalmology as well as at a national or international meetings. Teaching: Ophthalmology training in New Zealand usually involves one year as SHO, and five years as a vocational registrar. The last year of registrar training is typically spent in a Fellowship position overseas. The Medical Retina Fellow is expected to be actively involved in the clinical and surgical training of registrars. This includes involvement in interesting cases in the outpatient service as well as graciously stepping aside in the operating room if a registrar shows specific interest in a surgical procedure. Presentation of interesting cases at regular teaching sessions is also expected. 3 The Greenlane clinical centre is linked to the University of Auckland for teaching of medical students and fellows will frequently be involved in clinical teaching within the clinic and will also provide occasional lectures/tutorials. Participation in teaching of medical students and therapeutic optometry students is also an expectation of this role. Annual Leave: 5 weeks paid annual leave per year plus public holidays. Conference Leave: Applications are submitted for approval to the HoD, Department of Ophthalmology. There is no specific funding allocated for attending conferences but several sources are available. Evaluation: An evaluation after 2 months of the fellowship will be held to determine performance. A mid-term evaluation will also be held with the fellow to evaluate his or her performance and to give feedback regarding progress. Fellows are encouraged to provide feedback and express their comments on how their fellowship is progressing, including areas they would like to further develop. Fellowship Duration: 1 or 2 years as directly negotiated. Salary: The salary is paid at Research Fellow / Level 1 as per the University of Auckland Academic collective agreement. Weekly Duties The Fellow is expected to be on university or clinical sites at a minimum of Monday to Friday, 8:00 a.m. to 5:30 p.m. regardless of clinical activities. Attendance on Saturday mornings 9am-10.30am may occasionally be required to review inpatient cases. There is no official obligation to be involved in the on-call emergency roster, but the Fellow may chose to be on-call with the Medical Retina Consultants (1:4). All time not occupied by patient responsibilities must be used to further academic pursuits such as research and teaching. Failure to utilize non-clinical time in an appropriate fashion and unsatisfactory progress may result in curtailment of the Fellowship with one months notice. Except in exceptional circumstances all absences from clinic and operating room duties must be cleared six weeks in advance. Housing: Unfortunately no residence accommodation is available to support this post. Rental accommodation is widely available in Auckland. Average weekly rental can vary from $400 to $600 per week depending on the type of accommodation required. Application Process: Applications are by CV and cover letter to Professor Charles McGhee at the above contacts. Please include wih your application an up-to-date surgical log. Fellowships 4 normally run from July to June , but flexible start dates are considered. Generally, decisions are made approximately 6-12 months prior to the start date. Interviews are conducted by telephone and personal interviews are not generally required. Please check our website for closing date for sending applications For flexible start dates, applicants should enquire as to availability. Medical Registration: Non-New Zealand Nationals may apply. However, foreign medical graduates should note that they may not enroll in any programmes involving patient contact, nor practice medicine in New Zealand, unless they are registered by the Medical Council of New Zealand. This body is entirely independent of the universities: its website may be found at <http://www.mcnz.org.nz/>. Completion of an Australian, North American or UK vocational registrar/residency program usually makes medical registration fairly straightforward. Those applicants whose medical school was not taught in English and who do not speak English as their native language must have the following minimum International English Language Testing System (IELTS) scores as per the Council requirements: - Speaking 7.5 Listening 7.5 Writing 7.0 Reading 7.0 The Test of English as a Foreign Language (TOEFL) and Occupational English Test (OET) are not accepted by the Council as alternatives to IELTS. If you require to sit the IELTS examination (check criteria on the Medical Council website), please ensure you have cleared the examination at the time application. Fellow Responsibilities: 1. 2. 3. 4. 5. Obtain medical registration prior to the start of the programme Obtain practice insurance via Medical Protection Society Obtain visa and work permit from the NZ Immigration Service Obtain health insurance for family members while in New Zealand Adhere to the policies of the University of Auckland and Auckland District Health Board 6. Report to the University Department of Ophthalmology for administrative issues 7. Report to the consultant medical retina ophthalmologists for clinical issues 5